Appeal Resolution Supervisor supervises a team responsible for the processing of appeals. Assigns and prioritizes cases. Being an Appeal Resolution Supervisor responds to and resolves escalated issues. Coaches and trains team in the utilization of industry standards and best practices. Additionally, Appeal Resolution Supervisor requires a bachelor's degree. Typically reports to a manager. The Appeal Resolution Supervisor supervises a small group of para-professional staff in an organization characterized by highly transactional or repetitive processes. Contributes to the development of processes and procedures. To be an Appeal Resolution Supervisor typically requires 3 years experience in the related area as an individual contributor. Thorough knowledge of functional area under supervision. (Copyright 2024 Salary.com)
Under the general direction of the Manager of Health Information Management, the Audit and Appeals Coordinator coordinates Recovery Audit Contracting activities to ensure that deadlines are adhered to. The Audit and Appeal Coordinator is responsible for hospital compliance with all federal, state, and regulatory agencies to manage payer audits and appeals. Assumes the role of system administrator for the Audit and Appeals software product.
These duties will require the understanding of many complex and varying guidelines, systems, regulations and tools. The Audit and Appeals Coordinator will use critical thinking skills to manage an ever-evolving process that includes financial, clinical and legal components. The Audit and Appeals Coordinator will proactively work with GVH staff and physicians to put processes in place and to correct identified deficiencies that are impacted by retrospective denials.
Essential Functions:
Education and Experience:Bachelor's Degree and over 1 year to 3 years Healthcare Audit and Appeals experience required Licenses and Certifications:RHIA or RHIT certification, Upon hire, preferred
Licensed Practical Nurse/ Registered Nurse in PA – Licensed, Upon hire, preferred
Benefits:• Medical, Free Dental, Vision Insurance for full time and part time• 403B• Pension Plan• On-site discounted Child Care Center• Tuition Reimbursement up to $5250 per year• Free Life Insurance• Free Parking• Paid Time Off• Sick Time• Flexible Spending Accounts• Employee Referral Bonus
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